Professional Liability Specialist

ATHENS POSITION DETAILS

Position Title:

Professional Liability Specialist

Department:

Property & Casualty

Reports To:

Professional Liability Manager

FLSA Status:

Exempt

Job Grade:

16

ATHENS ADMINISTRATORS

Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!

Position Summary

Athens Administrators has an immediate need for a full-time Professional Liability Specialist to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, and WV). Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens’s offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week.

The Professional Liability Specialist is responsible for the review, analysis, and processing of complex claims within assigned authority limits and consistent with policy and legal requirements. These claims are typically high exposure and often entail litigation and complex coverage. The goal of the position is to ensure the delivery of quality service to a selected group of programs and customers while protecting their interests. The role would be supporting existing national programs (Addiction Treatment, Care Providers, Churches & Schools, Sports & Wellness, Firearms) for existing clients. Additionally, they will support select NY Labor Law claims, including sexual abuse and molestation claims in non-labor law program.

Primary Responsibilities

Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:

Advanced knowledge in the following areas: 1) professional liability claims handling concepts, practices and techniques, to include, but not limited to complex coverage issues, and product line knowledge, 2) advanced, functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills.

• Investigate, evaluate and determine settlement value or denial of liability for severe to major level claims
• Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level
• Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to program clients and senior level management
• Manage the litigation process through the retention of selected counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment
• Document and manage claims (i.e.: statements, diaries, draft reports) from inception to closure
• Ensure appropriateness of all coverages and payments
• Coordinate and work with dedicated vendor services such as law professionals, industry experts, company officials and client executives to manage professional claims and communications
• Facilitate interactions between insureds, claimants, clients, brokers, and attorneys in resolution of professional liability claims
• Lead and conduct comprehensive claim reviews and case analysis discussions with high profile accounts, brokers, and major case unit managers
• Provide superior customer service to high profile clients
• Meet with clients, attend hearings, and assist senior management with planning, forecasting and new business opportunities
• May assist management in hiring other professional liability examiners
• Provide guidance and serve as a technical expert to less experienced examiners
• May conduct meetings or training sessions to help develop less experienced examiners
• Attend all required meetings and educational seminars for professional development
• Maintain required licenses
  
  
  

Essential Position Requirements

The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.

• BA/BS college degree strongly preferred. HS Diploma or equivalent (GED) required.
• A professional designation or law degree preferred

• Relies on extensive experience and judgment to plan and accomplish goals with a minimum 10-12 years complex/major claims and professional liability experience
• Experience with sexual abuse/molestation claims
• Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL
• Additional State Adjuster License(s) may be required within 180 days
• Maintain licenses and continuing education requirements in all states
• Understanding of professional liability matters focused on bodily injury matters, sex abuse, some NY Labor Law and firearms matters
• Some familiarity and understanding of the London Insurance Market and program underwriting approach, including authority and handling standards unique to professional policies
• Experience with tort law, civil procedure, and contract law
• Experience with property and casualty insurance policies. Understanding professional liability exposure and unique coverage endorsements
• Experience with insurance laws, codes, and procedures
• Understanding of medical, legal terminology and liability concepts
• Proficiency in investigation and resolution of severe to major level casualty claims
• Advanced negotiation and litigation management skills
• Time Management and project management skills
• Superior verbal and written communication skills with strong attention to detail
• Excellent organizational skills and ability to multi-task
• Ability to type quickly, accurately and for prolonged periods
• Proficient in Microsoft Office Suite
• Ability to learn additional computer programs
• Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
• Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
• Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
• Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
• Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor
• Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
  
  

APPLY WITH US

We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf.

This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.

Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.

THANK YOU!

We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!

Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://www.athensadmin.com/careers/why-work-here